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20.435 (1) (hg) General program operations; health care information. The 5amounts in the schedule to fund the activities of the department of health and family 6services and the board on health care information under ch. 153 and to contract with 7the data organization under s. 153.05 (2r). The contract fees paid under s. 153.05 8(6m) and assessments paid under s. 153.60 shall be credited to this appropriation 9account.

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20.435 (1) (hg) General program operations; health care information. The 13amounts in the schedule to fund the activities of the department of health and family 14services and the board on health care information under ch. 153 and to contract with 15the data organization under s. 153.05 (2r). The contract fees paid under s. 153.05 16(6m) and assessments paid under s. 153.60 shall be credited to this appropriation 17account.

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20.435 (1) (hi) Compilations and special reports; health care information. All 21moneys received from user fees imposed under s. 153.65 (1) for the purpose of 22financing the costs of the department of health and family services of producing 23special data compilations or special reports under s. 153.65 and to contract with the 24data organization under s. 153.05 (2r).

AB907,5,7120.515 (1) (r) Benefit and coverage payments; data collection, analysis, and 2reporting. All moneys credited to the public employee trust fund for payment from 3the appropriate accounts and reserves of the fund of the benefits, contributions, 4insurance premiums and refunds authorized by ch. 40 for the respective benefit 5plans and for the costs of contracting for data collection, analysis, and reporting 6under s. 153.05 (2r). Estimated disbursements under this paragraph shall not be 7included in the schedule under s. 20.005.

AB907, s. 1412Section
14. 153.01 (2g) of the statutes is created to read:

AB907,5,1413
153.01 (2g) "Calculated variable" means a data element that is computed or 14derived from an original data item or derived using another data source.

AB907, s. 1515Section
15. 153.01 (3g) of the statutes is created to read:

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153.01 (3g) "Data organization" means a nonstock corporation organized 17under ch. 181 that is described in section 501 (c) (3) of the Internal Revenue Code, 18is exempt from federal income tax under section 501 (a) of the Internal Revenue 19Code, and, in its capacity as a public health authority, does all of the following:

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153.05 (1) (a) TheSubject to s. 153.455, the department shall collect from 11health care providers other than hospitals and ambulatory surgery centers, analyze, 12and disseminate health care information, as adjusted for case mix and severity, in 13language that is understandable to laypersons.

AB907, s. 1914Section
19. 153.05 (1) (c) of the statutes is created to read:

AB907,7,215
153.05 (1) (c) Subject to s. 153.455 (1) to (3), the data organization under 16contract under sub. (2r) may request health care claims information from insurers 17and administrators. The data organization shall analyze and publicly report the 18health care claims information with respect to the cost, quality, and effectiveness of 19health care, in language that is understandable by lay persons, and shall develop and 20maintain a centralized data repository. The data organization shall provide to the 21department, without charge, health care claims information collected by and reports 22produced by the data organization that the department requests. If s. 153.455 (4) 23applies, the department may request health care claims information, which may be 24voluntarily provided by insurers and administrators, and may perform or contract 1for the performance of the other duties specified for the data organization under this 2paragraph.

AB907, s. 203Section
20. 153.05 (2r) of the statutes is created to read:

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153.05 (2r) Notwithstanding s. 16.75 (1), (2), and (3m), from the appropriation 5account under s. 20.515 (1) (r) the department of employee trust funds may expend 6up to $150,000, and from the appropriation accounts under s. 20.435 (1) (hg) and (hi) 7the department of health and family services, in its capacity as a public health 8authority, may expend moneys, to contract jointly with a data organization to 9perform services under this chapter that are specified for the data organization 10under sub. (1) (c) or, if s. 153.455 (4) applies, for the department of health and family 11services to perform or contract for the performance of these services. As condition 12of the contract under this subsection, all of the following apply:

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(a) At least during the period of the contract, the data organization shall 14include as voting members of the board of directors of the data organization the 15secretary of health and family services and the secretary of employee trust funds, or 16their designees.

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(b) The data organization shall provide matching funds, which may include 18in-kind contributions, as specified in the contract.

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(c) Termination of funding and of services of the data organization under the 20contract or modification of the contract is subject to a determination made under s. 21153.455 (3).

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153.05 (3) (a) Upon request of the department for health care information 24relating to health care providers other than hospitals and ambulatory surgery 25centers and, if s. 153.455 (4) applies, for health care claims information as specified 1in sub. (1) (c), state agencies shall provide that health care information to the 2department for use in preparing reports under this chapter.

AB907, s. 223Section
22. 153.05 (3) (c) of the statutes is created to read:

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153.05 (3) (c) Upon request of the data organization under contract under sub. 5(2r) for health care claims information, insurers and administrators may provide the 6health care claims information to the data organization for use in preparing reports 7and developing and maintaining a central data repository under this chapter, and, 8if s. 153.455 (4) applies, insurers and administrators may provide the health care 9claims information as requested by the department.

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153.05 (5) (a) Unless sub. (13) applies, subject to s. 153.455, the department 12may require health care providers other than hospitals and ambulatory surgery 13centers to submit to the department health care information specified by rule under 14s. 153.75 (1) (n) for the preparation of reports, plans, and recommendations in the 15form specified by the department by rule.

AB907, s. 2416Section
24. 153.05 (5) (c) of the statutes is created to read:

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153.05 (5) (c) Subject to s. 153.455 (1) to (3), the data organization under 18contract under sub. (2r) may request insurers and administrators to submit to the 19data organization health care claims information for the preparation of reports, 20plans, and recommendations in the form specified by the data organization, 21including in standard electronic format. If s. 153.455 (4) applies, the department 22may request submission of the health care claims information from insurers and 23administrators in the form specified by the department, including in standard 24electronic format.

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153.05 (8) (a) Unless sub. (13) applies, subject to s. 153.455, the department 3shall collect, analyze and disseminate, in language that is understandable to 4laypersons, claims information and other health care information, as adjusted for 5case mix and severity, under the provisions of this chapter, as determined by rules 6promulgated by the department, from health care providers, other than hospitals 7and ambulatory surgery centers, specified by rules promulgated by the department. 8Data from those health care providers may be obtained through sampling techniques 9in lieu of collection of data on all patient encounters and data collection procedures 10shall minimize unnecessary duplication and administrative burdens. If the 11department collects from health care plans data that is specific to health care 12providers other than hospitals and ambulatory surgery centers, the department 13shall attempt to avoid collecting the same data from those health care providers.

AB907, s. 2714Section
27. 153.05 (8) (c) of the statutes is created to read:

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153.05 (8) (c) Subject to s. 153.455 (1) to (3), the data organization under 16contract under sub. (2r) may request, analyze, and publicly report, in language that 17is understandable to laypersons, health care claims information, as adjusted for case 18mix and severity, from insurers and administrators. Data from these sources may 19be obtained through sampling techniques in lieu of collection of data on all insureds, 20and data collection procedures shall minimize unnecessary duplication and 21administrative burdens. If s. 153.455 (4) applies, the department may request health 22care claims information, which may be voluntarily provided by insurers and 23administrators, and may perform or contract for the performance of the other duties 24specified for the data organization under this paragraph.

AB907,10,51153.05 (9) (a) TheSubject to s. 153.455, the department shall provide 2orientation and training to health care providers, other than hospitals and 3ambulatory surgery centers, who submit data under this chapter, to explain the 4process of data collection and analysis and the procedures for data verification, 5comment, interpretation, and release.

AB907, s. 296Section
29. 153.05 (9) (c) of the statutes is created to read:

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153.05 (9) (c) Subject to s. 153.455 (1) to (3), the data organization under 8contract under sub. (2r) shall provide orientation and training to insurers and 9administrators that submit data under this chapter, to explain the process of data 10collection and analysis and the procedures for data verification, comment, 11interpretation, and release. If s. 153.455 (4) applies, the department may perform 12or contract for the performance of the duties specified for the data organization under 13this paragraph.

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153.05 (12) (a) TheSubject to s. 153.455, the department shall, to the extent 16possible and upon request, assist members of the public in interpreting data in 17health care information disseminated by the department.

AB907, s. 3118Section
31. 153.05 (12) (c) of the statutes is created to read:

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153.05 (12) (c) The data organization under contract under sub. (2r) shall, 20subject to s. 153.455 (1) to (3), to the extent possible and upon request, assist 21members of the public in interpreting data in health care information disseminated 22by the data organization. If s. 153.455 (4) applies, the department may perform or 23contract for the performance of the duties specified for the data organization under 24this paragraph.

AB907, s. 331Section
33. 153.10 (1) of the statutes is amended to read:

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153.10 (1)TheSubject to s. 153.455, the department shall prepare, and submit 3to the governor and the chief clerk of each house of the legislature for distribution 4to the legislature under s. 13.172 (2), standard reports concerning health care 5providers other than hospitals and ambulatory surgery centers that the department 6prepares and shall collect information necessary for preparation of those reports. If 7s. 153.455 (4) applies, the department shall include in the reports under this 8subsection reports concerning any health care claims information the department 9collects or contracts to collect under s. 153.05.

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153.45 (1) (b) 9. Information that contains the name of a health care provider 15that is not a hospital or ambulatory surgery center, if the independent review board16department first reviews and approves the release
or if the department promulgates 17rules that specify circumstances under which the independent review board need not 18review and approve the release.

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153.45 (1) (c) (intro.) Custom-designed reports containing portions of the data 24under par. (b). Of information submitted by health care providers that are not 25hospitals or ambulatory surgery centers, requests under this paragraph for data 1elements other than those available for public use data files under par. (b), including 2the patient's month and year of birth, require review and approval by the 3independent review board before the data elements may be released. Information 4that contains the name of a health care provider that is not a hospital or ambulatory 5surgery center may be released only if the independent review boarddepartment6first reviews and approves the release or if the department promulgates rules that 7specify circumstances under which the independent review board need not review 8and approve the release. Reports under this paragraph may include the patient's zip 9code only if at least one of the following applies:

AB907,12,1712153.455Data organization; contract contingency.(1) Except as provided 13in subs. (2), (3), and (4), beginning on the date, if any, that is 60 days after the contract 14under s. 153.05 (2r) takes effect, the department shall cease collecting, for calendar 15quarters that occur after that date, health care information as specified under s. HFS 16120.14 (1), 2005 Wis. Adm. Code, in effect on the effective date of this subsection .... 17[revisor inserts date].

AB907,12,1818(2) Subsection (1) does not apply to ss. 153.21 (1) and 153.60 (1).

AB907,13,619(3) Beginning on the date, if any, that the secretary of health and family 20services and the secretary of employee trust funds determine that the data 21organization is not in compliance with the contract under s. 153.05 (2r) with respect 22to the performance of the collection and public reporting of information regarding the 23cost, quality, and effectiveness of health care, including the development and 24maintenance of a centralized data repository, or determine that there is insufficient 25statewide participation under the requirements of the contract, the secretaries may 1modify or terminate the contract. If the secretaries terminate the contract, they shall 2recommend to the department of administration that that department use a 3competitive request-for-proposal process to solicit offers from other organizations 4for performance of the services required of the data organization under the 5terminated contract. If no organization responds to the request for proposals or if a 6successor contract cannot be achieved, sub. (4) applies.

AB907,13,167(4) If the contract with the data organization is terminated under sub. (3) and 8no organization responds to the request for proposals or a successor contract cannot 9be achieved, the department, in its capacity as a public health authority, shall collect 10health care information, including as specified under s. HFS 120.14 (1), Wis. Adm. 11Code, in effect on the effective date of this subsection .... [revisors inserts date], and 12may request health care claims information, which may be voluntarily provided by 13insurers or administrators, under this chapter; shall analyze and disseminate, or 14contract for the performance of analysis and dissemination of, the health care 15information; and may analyze and disseminate, or may contract for the performance 16of analysis and dissemination of, the health care claims information.

AB907, s. 4117Section
41. 153.50 (intro.) of the statutes is created to read:

AB907, s. 4219Section
42. 153.50 (1) (b) 1m. of the statutes is created to read:

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153.50 (1) (b) 1m. "Patient-identifiable data" does not include calculated 21variables that are derived from patient-identifiable data and the dissemination of 22which does not permit patient identification.

AB907,14,31153.50 (1) (b) 2. (intro.) "Patient-identifiable data", for information submitted 2by health care providers who are not hospitals or ambulatory surgery centers and by 3insurers and administrators, means all of the following data elements:

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153.50 (3)Measures to ensure protection of patient identity. (intro.) To 6ensure that the identity of patients is protected when information obtained by the 7department or, by the entity under contract under s. 153.05 (2m) (a), or by the data 8organization under contract under s. 153.05 (2r) is disseminated, the department 9and, the entity, and the data organization shall do all of the following: